Interest in and use of person-centred pharmacy services - a Swiss study of people with diabetes

BACKGROUND: Diabetes is one of the most important chronic diseases and affects 9% of the world's population. To support these people in the day-to-day management of their treatments, pharmacies can offer professional pharmacy services. These are defined as one or more actions organized or provided in a pharmacy to optimize the process of care, with the goal of improving health outcomes and the value of healthcare. Such services have to be tailored to the needs and interests of patients. This study aimed to evaluate interest in and use of pharmacy services among people with diabetes in the canton of Vaud, Switzerland. METHODS: This cross-sectional study analysed self-reported data from 790 people with diabetes included in the CoDiab-VD cohort. Questions focused on sociodemographic and economic characteristics, diabetes and its management, and interest in and use of pharmacy services related to (1) medication intake and adherence and (2) diabetes and general health. Descriptive analyses were first conducted. Logistic regression analyses were then performed for pharmacy services that were of interest to ≥50% of respondents. RESULTS: The mean age of participants was 66 years, and the sample included more males (59%) than females. The pharmacy services that interested the most respondents were individual interview, pill boxes or weekly pill boxes, treatment plans, checks of all medications, first medical opinions from pharmacists and counselling on devices. Factors significantly associated with interest in pharmacy services were being older, having a lower self-efficacy score, taking more than three medications and having a positive opinion about pharmacists. CONCLUSIONS: This study provides key information on interest in and use of pharmacy services among patients with diabetes in Switzerland; it should help pharmacists individualize their services for patients

Atomic and Electronic Structure of a Rashba pp-nn Junction at the BiTeI Surface

The non-centrosymmetric semiconductor BiTeI exhibits two distinct surface terminations that support spin-split Rashba surface states. Their ambipolarity can be exploited for creating spin-polarized $p$-$n$ junctions at the boundaries between domains with different surface terminations. We use scanning tunneling microscopy/spectroscopy (STM/STS) to locate such junctions and investigate their atomic and electronic properties. The Te- and I-terminated surfaces are identified owing to their distinct chemical reactivity, and an apparent height mismatch of electronic origin. The Rashba surface states are revealed in the STS spectra by the onset of a van Hove singularity at the band edge. Eventually, an electronic depletion is found on interfacial Te atoms, consistent with the formation of a space charge area in typical $p$-$n$ junctions.Comment: 5 pages, 4 figure

Physicians', Nurses' and Pharmacists' Perceptions of Determinants to Deprescribing in Nursing Homes Considering Three Levels of Action: A Qualitative Study.

Background: Polypharmacy and the use of potentially inappropriate medications are frequent safety issues among nursing home (NH) residents. Deprescribing can significantly reduce the number of drugs used, medication costs, and mortality. This qualitative study sought to understand and compare the perceptions and practices of nurses, pharmacists, and physicians regarding deprescribing in Swiss NHs, referring to an implementation approach on three levels of action: the individual, the institution, and the healthcare system. Methods: Two focus groups were held with 21 participants: one focus group with 11 pharmacists, another with 10 nurses and six semi-structured interviews with physicians were conducted and focused on their individual experience and practices. They were audiotaped and fully transcribed, and a content analysis was performed using to MAXQDA (Ver 12) software. Results: (1) At an individual level, physicians were concerned by consequences of deprescribing in terms of safety. Nurses were closest to residents and stressed the importance of finding the right time, creating a bond of trust before deprescribing and considering the purpose of the stay in the NH. Pharmacists relied on structured guides for deprescribing, which led their reflection and practice. All professionals saw the complexity of the clinical situations, as well as residents' and relatives' fears of interruption of care. (2) At an institutional level, the professionals stressed the lack of time to discuss patients' health and treatment, while pre-existing interprofessional collaboration, specifically, quality circles, seemed useful tools to create common knowledge. In order to reduce prescriptions, better coordination between physicians, nurses, pharmacists and specialists seemed crucial. (3) At the health system level, funding still needs to be provided to consolidate the process, go beyond organisational constraints and ensure deprescribing serves the patient's wellbeing above all. Conclusions: At the individual level of implementation, the different healthcare professionals expressed specific concerns about deprescribing, depending on their defined role in NHs. Their perspective about the different levers to promote deprescribing at institutional and healthcare system levels converge towards interprofessional collaboration supported by the healthcare system. Specific funding and incentives are therefore needed to support a sustainable interprofessional team

BiTeCl and BiTeBr: a comparative high-pressure optical study

We here report a detailed high-pressure infrared transmission study of BiTeCl and BiTeBr. We follow the evolution of two band transitions: the optical excitation $\beta$ between two Rashba-split conduction bands, and the absorption $\gamma$ across the band gap. In the low pressure range, $p< 4$~GPa, for both compounds $\beta$ is approximately constant with pressure and $\gamma$ decreases, in agreement with band structure calculations. In BiTeCl, a clear pressure-induced phase transition at 6~GPa leads to a different ground state. For BiTeBr, the pressure evolution is more subtle, and we discuss the possibility of closing and reopening of the band gap. Our data is consistent with a Weyl phase in BiTeBr at 5$-$6~GPa, followed by the onset of a structural phase transition at 7~GPa.Comment: are welcom

Giant ambipolar Rashba effect in a semiconductor: BiTeI

We observe a giant spin-orbit splitting in bulk and surface states of the non-centrosymmetric semiconductor BiTeI. We show that the Fermi level can be placed in the valence or in the conduction band by controlling the surface termination. In both cases it intersects spin-polarized bands, in the corresponding surface depletion and accumulation layers. The momentum splitting of these bands is not affected by adsorbate-induced changes in the surface potential. These findings demonstrate that two properties crucial for enabling semiconductor-based spin electronics -- a large, robust spin splitting and ambipolar conduction -- are present in this material.Comment: 4 pages, 3 figure

Clinical evaluation of IDAS II, a new electronic device enabling drug adherence monitoring.

OBJECTIVE: The goal of this study was to evaluate clinically the acceptability of the IDAS II (Intelligent Drug Administration System), a new electronic device that enables drug adherence monitoring. METHODS: IDAS II was compared to another electronic monitor, the Medication Event Monitoring System (MEMS) in a randomised two-way cross-over study involving 24 hypertensive patients treated with irbesartan. Patients used each device for 2 months. The main parameter of evaluation was the patients' opinion on both devices. Rates of adherence and blood pressure were also assessed. RESULTS: Most patients considered both devices to be reliable reminders (IDAS II: 75%;MEMS: 84%, p = ns). Ten patients (42%) preferred the MEMS, while 11 (46%) preferred the IDAS II; three (12%) expressed no preference. Patients found the MEMS device easier to use than the IDAS device (p &lt; 0.001) but appreciated the IDAS blister packs better than the MEMS bulk packaging (p &lt; 0.01). Over the 4-month period, the median "taking adherence" was excellent (99.2%) and comparable with both devices. However, the regularity of drug intake timing was higher with the IDAS II (p &lt; 0.01). CONCLUSION: IDAS II, a new electronic device enabling drug adherence monitoring without reconditioning of the drugs appears to be a well-accepted device. Overall, practicability and acceptability of the IDAS II and the MEMS device were similar. Thus, IDAS II could be a useful tool for the management of long-term therapies

Interdisciplinary Medication Adherence Program: The Example of a University Community Pharmacy in Switzerland.

The Community Pharmacy of the Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire, PMU), University of Lausanne, developed and implemented an interdisciplinary medication adherence program. The program aims to support and reinforce medication adherence through a multifactorial and interdisciplinary intervention. Motivational interviewing is combined with medication adherence electronic monitors (MEMS, Aardex MWV) and a report to patient, physician, nurse, and other pharmacists. This program has become a routine activity and was extended for use with all chronic diseases. From 2004 to 2014, there were 819 patient inclusions, and 268 patients were in follow-up in 2014. This paper aims to present the organization and program's context, statistical data, published research, and future perspectives

Momentum resolved spin dynamics of bulk and surface excited states in the topological insulator Bi2Se3\mathrm{Bi_{2}Se_{3}}

The prospective of optically inducing a spin polarized current for spintronic devices has generated a vast interest in the out-of-equilibrium electronic and spin structure of topological insulators (TIs). In this Letter we prove that only by measuring the spin intensity signal over several order of magnitude in spin, time and angle resolved photoemission spectroscopy (STAR-PES) experiments is it possible to comprehensively describe the optically excited electronic states in TIs materials. The experiments performed on $\mathrm{Bi_{2}Se_{3}}$ reveal the existence of a Surface-Resonance-State in the 2nd bulk band gap interpreted on the basis of fully relativistic ab-initio spin resolved photoemission calculations. Remarkably, the spin dependent relaxation of the hot carriers is well reproduced by a spin dynamics model considering two non-interacting electronic systems, derived from the excited surface and bulk states, with different electronic temperatures.Comment: 5 pages and 4 figure